WB-DWI联合常规CT/MRI在恶性肿瘤全身转移中的应用价值

The Values of WB-DWI in Combination with Convensional CT/MRI in Diagnosing Systemic Metastases from Malignant Tumors

目的探讨全身弥散加权磁共振成像(whole body diffusion-weighted MRI,WB-DWI)及其联合常规CT/MRI诊断恶性肿瘤转移灶的临床应用价值。材料与方法对76例恶性肿瘤患者进行WB-DWI检查,所有恶性肿瘤患者均在7天内完成常规CT及MR检查。采用双盲法由两名资深影像医师对所有WB-DWI图像以及CT、MR图像进行分析。所有转移瘤均经手术或穿刺后病理学检查、影像学资料、实验室检查或随访至少3个月证实。统计单独应用WB-DWI和WB-DWI联合常规CT/MRI对转移瘤诊断的灵敏度、特异度和准确度;比较两者在转移瘤的诊断中是否存在统计学差异。结果单独应用WB-DWI诊断转移瘤的灵敏度为75.9%,特异度为25%,准确度为69.8%;WB-DWI联合CT/MRI诊断转移瘤的灵敏度为94.8%,特异度为67.5%,准确度为91.5%。经卡方检验,两者对恶性肿瘤全身转移灶的检出率具有统计学意义(P<0.05)。结论 WB-DWI联合CT/MRI是诊断恶性肿瘤全身转移灶合理、有效的检查手段,具有较高的临床应用价值。

Objective To explore the values of whole body diffusion-weighted MRI （WB-DWI） and WB-DWI in combination with conventional CT/MRI in diagnosis of metastases of malignant tumors. Materials and Methods 76 patients with malignant tumors underwent WB-DWI examinations. Patients with malignant tumors underwent conventional CT and MRI examinations within a week, few of which underwent enhanced CT OR MRI scan. Two experienced imaging physicians analyzed all of WB-DWI, CT and MR images by double-blind method. All metastases were confirmed by surgery or puncture pathology, imaging data and laboratory tests or follow-up at least 3 months. The sensitivity, specificity and accuracy in the diagnosis of metastases of WB-DWI and WB-DWI in combination with conventional CT/MRI were compared. Results The sensitivity, specificity and accuracy in detecting systemic metastases from malignant tumors were 75.9%, 25%, 69.8% respectively by WB-DWI, and 94.8%, 67.5%, 91.5% respectively by WB-DWI in combination with conventional CT/MRI. By the chi-square test, there were statistical differences in detecting systemic metastases from malignant tumors between the two methods （P〉0.05）. Conclusion WB-DWI in combination with conventional CT/MRI is a reasonable and effective screening tool in detecting systemic metastases from malignant tumors, with high clinical value.